Ati Endocrine System Meds (Diabetes)

Front 1

rapid acting insulin

Back 1

lispro (Humalog)

onset: less than 15 min
peak 0.5-1 hour
duration: 3-4 hour

other: insulin aspart- (Novolog)
insulin gluclisine (Apidra)

Front 2

short acting

Back 2

regular insulin Humulin R
onset 0.5- 1 hour
peak 2-3 hour
duration- 3-4 hr

regular insulin (Novolin R)

Front 3

intermediate acting

Back 3

NPH insulin Humulin N
onset: 1-2 hours
Peak: 4-12 hours
duration: 18-24 hours

insulin detemir (Levemir)

Front 4

long acting

Back 4

Insulin glargine (Lantus)
onset: 1 hr
peak: none
duration: 24 hours

Front 5

premixed insulins

Back 5

70% NPH and 30% Regular (Humulin 70/30)

75% insulin lispro protamine and 25% insulin lispro (Humalog 75/25)
mixture of intermediate acting and rapid acting

Front 6

insulin MOA

Back 6

decreases glucose levels
converts glucose into glycogen
moves potassium into cells (along with glucose)

Front 7

insulin uses

Back 7

glycemic control of DM (type 1, type 2, gestational) to prevent complications

Front 8

insulin adverse

Back 8

risk for hypoglycemia (too much insulin)- monitor for hypoglycemia

administer glucose- for conscious patients administer a snack of 15 g carbohydrate
if client is not fully conscious- administer glucose parenterally

lipohypertrophy- systematically rotate injection sites

Front 9

insulin interactions

Back 9

sulfonylureas, meglitinides, beta blockers, alcohol have additive hypoglycemic effects with concurrent use

thiazide diuretics and glucocorticoids may raise blood glucose levels

beta blockers may mask SNS response to hypoglycemia

Front 10

insulin admin

Back 10

when mixing short-acting insulin with longer acting insulin, draw the short acting insulin up into the syringe first then the longer acting insulin.

Insulin suspensions: gently rotate vial between palms to disperse the particles throughout the vial

do not administer short acting insulins if they appear cloudy or discolored

insulin glargine and insulin detmir are clear- not admin IV and should not be mixed in a syringe with other insulin

lispro, aspart, glulisine, and regular insuline SubQ injection, infusion, IV route

administer NPH- subq

ensure proper insulin storage

Front 11

oral antidiabetics

Back 11

sulfonylureas
meglitinides
biguanides
thiazolidinediones (Glitazones)
pioglitazone (Actos)
alpha glucosidase inhibitors
gliptins

Front 12

sulfonylureas first gen

Back 12

tolburamide (Orinase)
other: chlorpropamide

Front 13

sulfonylureas second gen

Back 13

glipizide (Glucotrol, Glucotrol XL)

other: glyburide (Diabeta), glimepiride (Amaryl)

Front 14

sulfonylureas MOA

Back 14

insulin release from the pancreas

Front 15

meglitinides

Back 15

Proto: repaglinide (Prandin)
other: nateglinide (Starlix)

Front 16

meglitinide MOA

Back 16

insulin release from the pancreas

Front 17

biguanide

Back 17

proto: metformin HCL (Glucophage)

Front 18

biguanide MOA

Back 18

reduces production of glucose within the liver though suppression of gluconeogenesis
increases muscles glucose uptake and use

Front 19

thiazolidinediones (Glitazones)

Back 19

pioglitazones (Actos)

Front 20

thiazolidinediones MOA

Back 20

increases cellular response to insulin by decreasing insulin resistance
increased glucose uptake and decreased glucose production

Front 21

alpha glucosidase inhibitors

Back 21

proto: acarbose (Precose)
other meds: miglitol (Glyset)

Front 22

alpha glucosidase inhibitor MOA

Back 22

slows carbohydrate absorption and digestion

Front 23

gliptins

Back 23

sitagliptin (Januvia)

Front 24

gliptins MOA

Back 24

augments naturally occuring incretin hormones which promote release of insulin and decrease secretion of glucagon
lowers fasting and postprandial blood glucose levels

Front 25

oral antidiabetics use

Back 25

control blood glucose levels in type 2 diabetes
metformin HCL is used to treat PCOS

Front 26

glipizide and repaglinide adverse

Back 26

hypoglycemia

Front 27

metformin HCL adverse

Back 27

GI effects
Vitamin B and folic acid deficiency
lactic acidosis (hyperventiliation, myalgia, sluggishness, somnolence)- can be treated with hemodialysis

Front 28

pioglitazone adverse

Back 28

fluid retention
elevations in LDL cholesterol
hepatotoxicity

Front 29

acarbose adverse

Back 29

intestinal effects
anemia
hepatotoxicity

Front 30

oral antidiabetics contraindications

Back 30

renal failure, hepatic dysfunction, heart failure
contraindicated in the treatment of diabetic ketoacidosis
metformin is contraindicated for clients who have severe infections, shock, hypoxic condition
acarbose is contraindicated in GI disorders
pioglitizone is contraindicated in HF, bladder cancer, active hepatic disease

Front 31

glipizide interactions

Back 31

alcohol- result in dislfiram-like reaction (intense nausea, vomiting, flushing, palpitations)
alcohol, NSAIDS, sulfonamides, ranitidine (Zantac) and cimetidine (Tagament)- additive hypoglycemic effect
beta blockers- mask SNS response to hypoglycemia

Front 32

repaglinide and pioglitazone interactions

Back 32

concurrent use of gemfibrozil (Lopid)- hypoglycemia

Front 33

metformin interactions

Back 33

alcohol- lactic acidosis
iodine-containing contrast media- kidney failure

Front 34

acarbose interactions

Back 34

sulfonylureas or insulin- hypoglycemia
metformin- additive GI effects and risk for hypoglycemia

Front 35

oral antidiabetics admin

Back 35

glipizide- 30 min prior to a meal
repaglinide - eat within 30 min of admin 3 times a day
metformin- take immediate release tabs twice a day with breakfast and dinner- take sustained tabs once a day with dinner
pioglitazone- once a day, with or without food
acarbose- take with first bite of food, three times per day
sitagliptin- once a day with or without food

Front 36

amylin mimetics

Back 36

pramlintide (Symlin)

Front 37

amylin mimetics MOA

Back 37

mimis the actions of naturally occuring peptide homone amylin, resulting in reduction of postprandial glucose levels

Front 38

amylin mimetics USE

Back 38

supplemental glucose control for clients with type 1 and type 2 diabetes
used in conjunction with insulin or an oral antidiabetic medication, usually metformin or a sulfonylurea

Front 39

amylin mimetics adverse

Back 39

nausea
reaction at injection site

Front 40

amylin mimetics contraindications

Back 40

kidney failure
thyroid disease, osteoporosis, alcoholism

Front 41

amylin mimetics interactions

Back 41

insulin increases risk for hypoglycemia
concurrent use of pramlintide with meds that slow gastric emptying time, such as opioids, or meds that delay food absorption such as acarbose

Front 42

amylin mimetics admin

Back 42

administer prior to meals using thigh or abdomen
keep onopened vials in the refrigerator and do not freeze

Front 43

incretin mimetics

Back 43

exenatide (Byetta)
other: liraglutide (Victoza)

Front 44

incretin mimetics MOA

Back 44

mimics effects of naturally occuring glucagon like peptide 1 and thereby promotes release of insulin, decreases secretion of glucagon, and slows gastric emptying
Fasting and postprandial blood glucose levels are lowered

Front 45

incretin mimetics use

Back 45

supplemental glucose control for clients who have type 2 diabetes
may be used in conjunction with an oral antidiabetic, usually metformin or a sulfonylurea

Front 46

incretin mimetics adverse

Back 46

GI effects
pancreatitis

Front 47

incretin mimetics contraindications

Back 47

kidney failure, UC, Crohn's
older adults and clients with renal or thyroid disease

Front 48

incretin mimetics interactions

Back 48

oral contraceptives, antibiotics, acetaminophen absorption is delayed
concurrent use of sulfonylurea increases risk of hypoglycemia

Front 49

incretin mimetics admin

Back 49

give injection within 60 min before the morning and evening meal
NEVER administer after a meal

Front 50

incretin mimetics effectiveness

Back 50

preprandial glucose levels- 90-130 mg/dl
HbA1c less than 7%

Front 51

hyperglycemic agent

Back 51

proto: glucagon (GlucaGen)

Front 52

hyperglycemic agent MOA

Back 52

increases blood glucose levels by increasing breakdown of glycogen into glucose

Front 53

hyperglycemic agent use

Back 53

emergency management of hypoglycemic reactions, such as insulin overdose in clients who are unable to take oral glucose
decrease in gastric motility in clients undergoing radilogical procedures of the stomach and intestines

Front 54

hyperglycemic adverse

Back 54

GI distress

Front 55

hyperglycemic contraindications

Back 55

glucagon is ineffective for hyoglycemia resulting from inadequate glycogen stores (starvation)
caution to those with cardiovascular disease

Front 56

hyperglycemic effectiveness

Back 56

blood glucose level greater than 50mg/dl